Crisis pregnancy center practices suggest ‘need for greater scrutiny’

Key takeaways:

• Many crisis pregnancy centers advertise unproven and potentially harmful treatments, such as abortion pill reversal.
• More regulatory oversight is needed for nonmedical centers offering health care services.

Most nonprofit crisis pregnancy centers in the U.S. advertise medical services such as abortion education and sexually transmitted infection testing but also abortion pill reversal, an unproven and potentially harmful treatment, data show.

In a database review of websites for crisis pregnancy centers, which are nonmedical entities that promote alternatives to abortion, researchers also highlighted a growing nationwide network. As of March, Texas, California and Florida lead the nation with a combined 367 such centers.

“While crisis pregnancy centers provide some community services, there is a clear need for greater regulation and transparency regarding the medical services they offer,” John W. Ayers, PhD, MA, vice chief of innovation in the division of infectious diseases and global public health at UC San Diego School of Medicine, told Healio. “The widespread promotion of unproven and potentially dangerous treatments, like abortion pill reversal, and the unregulated provision of services such as ultrasounds and STI testing, puts women’s health at risk. Health care providers, policymakers and the public must be aware of these practices, and we need stronger oversight to ensure that women receive safe, evidence-based care.”

Researchers reviewed crisis pregnancy center websites via ChoiceWatch.org, a public database with more than 470,000 webpages from 1,825 crisis pregnancy center websites. Researchers reviewed the websites, archived between September 2023 and March 2024, to verify they represented a crisis pregnancy center, which they defined as a center primarily providing services to discourage abortion, and analyzed the ChoiceWatch.org database for keywords related to medical services (ie, abortion education, abortion pill reversal, pregnancy tests, STI testing and ultrasonography) and social services (ie, adoption, men’s social support, parenting and postabortion social support).

Researchers also conducted crisis pregnancy center counts by state (raw and per 100,000 women aged 15-44 years) and national service rates.

The findings were published in a research letter in JAMA Internal Medicine.

Among 1,825 discovered crisis pregnancy centers, Texas had the most in the U.S. with 143, followed by California (n = 126) and Florida (n = 98). Per 100,000 women aged 15 to 44 years, Montana (7.45; 95% CI, 3.49-11.85) and Wyoming (6.48; 95% CI, 1.86-11.12) had the most crisis pregnancy centers. Utah (0.83; 95% CI, 0.28- 1.52), Hawaii (0.75; 95% CI, 0-1.89) and Washington, D.C. (0.56; 95% CI, 0-1.68), had the fewest, according to researchers.

Among 1,600 fully indexed crisis pregnancy center webpages, 91.3% advertised medical services, including pregnancy tests (84.9%), ultrasonography (76.7%), STI testing (53.8%), abortion education (51.9%) and abortion pill reversal (30.4%).

“It is important to note that even those who hold strong antiabortion views should support the abandonment of harmful practices like abortion pill reversal,” Ayers told Healio. “Women who seek help at crisis pregnancy centers after initiating a medication abortion are often vulnerable and are being sold unproven treatments — essentially, dangerous ‘snake oil.’ Regardless of one’s position on abortion, we can all agree that lying to and potentially endangering women in these vulnerable situations is wrong.”

Overall, 89.6% of the crisis pregnancy center websites advertised social services, including adoption (82.8%), parenting (62.1%), postabortion social support (39.4%) and men’s social support (13.6%).

“This is not to say that all crisis pregnancy center practices are questionable,” Ayers told Healio. “We found 90% of centers advertised social services, including adoption, parenting, postabortion social support and men’s social support. Providing these social services can be incredibly beneficial.”

The researchers noted that they were unable to verify website claims or determine how many locations or clients each crisis pregnancy center served, noting that the actual crisis pregnancy center population is unknown. The findings suggest a “need for greater scrutiny” of crisis pregnancy center practices, particularly their service provision and provider qualifications, the researchers wrote.

“Health care providers, policymakers and the public must be made aware of these practices, and stronger oversight is needed to ensure that women receive safe, evidence-based care,” Ayers told Healio. “Our study calls for increased transparency and regulation to protect women from misinformation and unsafe medical practices, ensuring that their health and well-being are prioritized.”

For more information:

John W. Ayers, PhD, MA, can be reached at ayers.john.w@gmail.com; X (Twitter): @JohnWAyersPhD.